FAQ - Hematoma, Epidural, Spinal
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What chemicals are used to take away pain, especially those that paralyze or numb us like spinal epidural?

We request an epidural with little or no knowledge of what is actually being put into our brain and spinal water. It seems, we have half the story and the other half is never questioned. As most are in the throes of pain :( when being administered this cocktail that takes away their pain:), and one never stops to question, what it is...so, what is it?

The primary component in a spinal is a local anaesthetic agent, usually Marcain Heavy 0.5%. This works by binding to the synapses at the spinal cord, preventing the transmission of nerve signals, both pain and movement. This is mixed with a low dose of an opiate; usually diamorphine or fentanyl - this works on the whole system as an analgesic. The block wears of as the agent is washed out of the cerebro-spinal fluid (CSF), into the bloodstream, then metabolised by the liver and kidneys. This technique is used in caesarian section, and will not be used for normal vaginal delivery due to the paralysing effect on the uterine muscles

An epidural is similar, but instead of going into the spinal canal and the CSF, it bathes the nerve roots outside of the main spinal canal in an area called the para-dural space; and effects the pain nerves in the first instance - it takes a long time for motor function to be affected. With this, an agent such as ropivicaine, or bupivicaine, is used in higher volumes, but lower concentrations. These agents are absorbed into the bloodstream through the covering of the spinal cord, and are metabolised and excreted in the same way as above. This is the technique used in normal labour, as it should not affect the ability to push

In incredibly rare cases (1 in 100,000); these blocks fail to work. This is usually due to poor insertion technique. In even more rare situations (1 in 1,000,000) the mother is immune to the agents. Due to the length of time it takes for the local anaesthetic and opioid to enter the bloodstream from the spine or epidural, it does not cross the placenta to baby.

Hope this helps you.  (+ info)

What if I refuse an epidural or spinal tap?

I am not pregnant but we are TTC. I want to have a natural birth and plan on it but things don't always go as planned so what if for some reason a c-section is mandatory and I REFUSE an epidural or spinal tap? Then what?
I don't want an epidural due to the possibility of paralysis...can they put me under?

I completely understand wanting a natural birth, but do you really think that you would risk your babies life by refusing an epidural or spinal, if you did need a C section? The other alternative would be going under general anesthesia, but that has more risks to the baby.  (+ info)

How long does a spinal epidural last?

I have very bad pain in my left shoulder and arm from a bulging disc "C-7 & C-6" In my cervical spine. I keep hearing about these epidural shots that they can give you for pain. Can anyone tell me how long they last "kill the pain" and how bad does it hurt to get one of these shots? And how well do they really work? Thank you very much for any insight you can offer.

Hi, well you are in luck! That's what I did for a living for 3 years! Plus I have had them myself too. My bad disc are C4,5,6,7 will eventually be fused, my last injection was C-4 selective nerve root block, OMG I thought I'd die! The doc was horrible not at all like the ones I worked for. I was in so much more pain after wards I had to be put in a cervical collar! My husband has had 4 years of injections, he goes for a series of three twice a year, doc doesn't want him to have too much steroids, he has already had his fusion now the disc below it is crumbling. There are CESI that is cervical, and the LESI's lumbar, and of course TPI's (trigger points, in the center around other areas and in joints). It is Marcaine (a numbing medicine) and deprol medrol (the steriod used) one needle does it all at once, it is done under fluoroscopic x-ray so the Doctor can see your vertebra (ask for a picture too! they will give it too you if you ask!) Guides the needle, if you are w/c they will have you do lots of them probably, if it was from an accident, it just helps put off surgery a little longer. I can send you a photo of my neck w/ the needle in if you want me too, I can send you my email. They last anywhere from a few days to a few months and sometimes not at all. Everyone is different. It usually does make you more mobile, but no it doesn't kill the pain, maybe dulls it some, but you will still need your medications. The first 2 days after-wards hurts the most while the steroid disperes around the area. I'd take my meds before going in at least 30 ,minutes prior to the injection, just no blood thinners 3 days before the injection. Yes, they do work, most of the time. Feel free to message me, if you need too. I worked in pain mgt. with a DO and a MD both were anesthesiologists. Good Luck! Tash  (+ info)

C-section: Did you get to choose between an epidural and spinal?

This question is for those who have had a c-section:

Did your doctor give you the choice between an epidural and a spinal?

Definitely go for the spinal. I had a planned C-section in March. I actually went in thinking that I wanted to have an epidural because that's what I had with my first c-section and I chose a spinal(I was given a choice).

A spinal makes all of the difference in the world. I was up walking within 8 hours of my c-section this time. And as far as pain management is concerned, it is just as effective.  (+ info)

Has anyone had a spinal block or epidural?

And what is the difference between that and an epidural, in terms of pain relief, effectiveness, and recovery? Thanks

* 31 weeks pregnant with #1, and going over options.

A spinal block here in Canada is only used under two conditions, previously an epidural failed to work to its full effectiveness and in the case of a C section. What it is is basically the same thing as an epidural only the needle goes in to the spine as apposed to just the around it. Its very similar to a spinal tap.

I have not had a spinal block but I have had 2 spinal taps one when I was little and one in my teens and well I don't want to say it doesn't hurt but its really not that bad.As long as your still and I mean STILL and are focused on something. Its more of a discomfort than pain.

I had an epidural with my son. And because of the spinal taps I am terrified of needles and I am proud to say getting the epidural is a breeze. The freezing is like a little pinch than I felt nothing ( well other than contractions) Some women say and even the anesthesiologist say that it feels more like pressure....I didn't even feel that.The I.V needle was 1000 times worse than the epidural. In my case after going through getting the epidural....it didn't work....at all I felt everything...dear god everything

If your brave do it all natural. Hurts like a SOB but worth it. Your up and walking around moments after, your able to pee by yourself afterwards( were I gave birth a nurse had to be present after in case of leg muscle failure) its really just better for you. And don't worry if you think you wont be able to handle the pain. I didn't think I could either, In fact I signed an agreement to pay for them knock me out if I asked for it. And Im so willing to do it again already  (+ info)

im scared to give birth. what are my options besides epidural and spinal block? is it safe to be put to sleep?

im in my 9th month of pregnancy and every time i start to talk to think about giving birth i cry so hard and panic that i almost cant breath.. im scared that when its time to deliver i may hurt myself or the baby because i cant breath..b/c im scared. is it safe to be put to sleep? also whats the difference between epidural and spinal block?

They used to drug women out of their minds, but today I would say most doctors would be unwilling to put you to sleep. An epidural may also not be a great option for you because you have to sit very very still (even through a contraction) while they put the needle into a very specific spot on your back. If you are so terrified, you may find it difficult to stay still enough.

Your panic sounds serious enough that you need to have a real sincere discussion with your provider about your options.

There is something called a sterile water block which is a wonderful option because it is a drug free form of pain relief that works for about 90 minutes at a time.

You may also want to look into self hypnosis (or hypnosis with an expert's guidance). It is a very powerful tool for pain relief. Hypnobabies and hypnobirthing are both programs you can look into. Hypnosis is powerful enough that women with allergies to anesthesia can be hypnotized and go through major surgery like a csection. so it is certainly strong enough to help you through a totally natural process that your body was built to do!  (+ info)

Does a spinal block hurt more than an epidural?

I am having a c-section in January and with my first son I had an epidural, so I was just wondering if they felt the same or if one hurt more than the other.
Like does it hurt more to get the shot or is it the same?

Its the same. The difference is that they leave the epidural in with a catheder (sp?), but you can't feel it. The spinal block is just a shot that lasts 90 minutes. I've had both. With both, the only part that hurts is the shot to numb your back, which is exactly the same no matter which way you go. It feels like a stinging (like a bee sting) for about 3 seconds. Thats it, no more pain. I did get an electric shock feeling that ran down my leg, which lasted less than 1 second and suprised me but did not hurt.

The medicine in the spinal block is much stronger than an epidural, it will make you COMPLETELY numb, you won't be able to feel anything or control your muscles. With an epidural you may or may not still have sensation or be able to control your muscles. With mine, I had no sensation and did not feel any pain at all. I couldn't move my legs, but I was able to push without a problem. It was a very easy, completely painless birth and I would definately recommend the epidural. I had to have a C section with my second and had the spinal block. When they gave it to me, I couldn't even hold myself sitting up, they had to hold onto me to lay me down and I couldn't move or feel anything.  (+ info)

Can you get an epidural if you've had a spinal fusion?

When I was 16 I had to have my L5-S1 vertebra's fused because of a ruptured disk. Since then I've heard from a few different sources that if I ever got pregnant that I wouldn't be able to have an epidural during the delivery because of my fusion. So my question is, if I were ever to get pregnant could I have an epidural even though I have a spinal fusion?

I think you can if the fusion was an L5-S1. They place it higher. You can consult with an anesthesiologist before you ever become pregnant if you are thinking it would be that big of an issue.  (+ info)

Did you get an epidural or spinal block for your c-section?

For my first baby I was induced and then was given an epidural. Later I had to be taken to get an emergency c-section. This second time around I am scheduled to have a c-section and was wondering what would the difference be. Which one do you feel is better if you have had both?

  (+ info)

Whats the difference between the epidural and a spinal block?

Or are they the same?
Whats the difference?
And which one is used for a c-section?

A spinal is a single injection where the drug is actually put into the fluid around your spinal cord. It's intended for total numbness and what drug they use and how much decides how long it lasts. I've had them for knee surgeries and I SAW my legs being moved but had no idea.

An epidural doesn't puncture the dura but stays in the area around it. It usually involves a catheter and can be used for longer periods of time for labor or post-op pain control.

When women have a trial of labor that ends in a c-section it isn't uncommon for them to redose her epidural heavily and do the surgery and she's totally comfortable. Often times spinals are used for planned procedures and things where they know how long they'll need the anesthesia to last. Either one will give good pain control for a c-section and before any cutting is done your sensation is tested so no worries there.  (+ info)

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